A civil rights lawsuit arising from the death of a psychiatric patient at Parkland Memorial Hospital may proceed, a federal judge ruled, saying the case sufficiently argued that the man’s constitutional rights had been violated.

Meanwhile, a federal review of care at Parkland — triggered by the same patient’s death — is now focused on safety problems discovered last week. Those include problems with the safe storage of equipment and sanitation in the hospital’s kitchen, among other areas, according to sources familiar with the inspection.

The U.S. Centers for Medicare & Medicaid Services and the state health department, which is performing the inspections for the federal government, declined to provide any details about the findings. Parkland officials did not respond to requests for comment.

The Parkland inspection process caps nearly two years of rare federal safety oversight. It is designed to determine whether the hospital has fixed widespread care failures that have jeopardized patients in recent years. If Parkland doesn’t pass scrutiny, it stands to lose $400 million a year in federal funding.

Inspection suspended

Last week, inspectors began what was thought to be a final review of the hospital. But they suspended their review after five days for unspecified reasons.

“The survey of Parkland is still open,” said David Wright, the CMS regional deputy administrator.

He said his regulatory team was focusing its attention on “concerns” uncovered last week, but he would not elaborate. CMS sometimes postpones completion of its surveys to review the severity of problems, Wright said, adding that inspectors would return to the hospital by the end of the summer.

The February 2011 death of psychiatric patient George Cornell sparked a series of inspections that led to the massive oversight program. After regulators learned of Cornell’s death from The Dallas Morning News, they ruled that he was illegally restrained face-down far longer than the law allows before he stopped breathing.

The restraints occurred without a doctor’s order, without close monitoring by a nurse and without effective training of the psych techs who wrestled him to the ground, health officials said. Cornell had twice been given a drug combination of Haldol, Ativan and Benadryl, records show.

The ruling Wednesday by U.S. District Judge David Godbey for the Northern District of Texas came in response to several defendant motions to dismiss the case. They argued that, as employees of government entities, they were immune from liability and that Pena’s allegations were ambiguous.

But Godbey ruled Pena had “sufficiently stated her claims” that Cornell’s constitutional rights were violated. Cornell’s case met a test upheld by other court rulings that requires a person to be “involuntarily taken into custody” and held against his will, the judge wrote.

“Cornell could not have left the hospital,” Godbey said. “Cornell was drugged and left on the floor of a locked seclusion room and, in that state, he simply could not have departed.”

“Anytime you get past this point, you have a legitimate case,” said Jackson, who reviewed the judge’s 36-page ruling for The News. “Most of these claims get washed out of the court at this point. Claims against government actors are held to a very tight standard. And you don’t see hospital cases happen very often.”

Furthermore, he said, the federal courts in Dallas are part of the U.S. 5th Circuit, which has upheld strict limitations on such suits.

“You have to understand that this is the most conservative jurisdiction in the country,” said Jackson. “It appears the court took a good hard look at this and said this is a good hard case.”

The ruling allows various claims in the suit to proceed against Parkland officials who were forced out of office during the last two years, including Dr. Ron Anderson, former chief executive; Dr. John Jay Shannon, former chief medical officer; and Nancy Schierding, the former director of nursing for Parkland’s psychiatric emergency services.

UTSW defendants include Dr. Kevin Brown, the attending physician at the time of Cornell’s death, and Shawn Chambers, a resident doctor-in-training.

The U.S. Justice Department has separately reviewed psychiatric care at Parkland, including Cornell’s death, to determine whether to launch a civil rights investigation.

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UT Southwestern Medical Center and Parkland Memorial Hospital are known for their contributions to medical research and public health. But have those accomplishments come at a cost to quality healthcare? The Dallas Morning News investigates patient safety and allegations of lax supervision of doctors in training at the public institutions.